Table 9.

Postprocedural care in prospective studies of ventricular tachycardia catheter ablation

Study	Postprocedure NIPS	AAD type	AAD duration	Follow-up	ICD programming	Anticoagulation postablation	Bleeding and thromboembolic events (ablation arm)
Calkins 2000 (S10.1.2.5)	No	Patients were continued on the type of antiarrhythmic therapy they had received before ablation.	At least the first 3 months after hospital discharge	Evaluation at 1, 3, 6, 9, 12, and 24 months after ablation	Not specified	Not specified	Four of 146 (2.7%) stroke or TIA, 4 (2.7%) episodes of pericardial tamponade
SMASH-VT 2007 (S10.1.2.6)	No	No patient received an AAD (other than beta blockers) before the primary endpoint was reached.	N/A	Followed in the ICD clinic at 3, 6, 9, 12, 18, and 24 months; echocardiography at 3 and 12 months	Not specified	Oral anticoagulation 4–6 weeks, aspirin if fewer than 5 ablation lesions	One pericardial effusion without tamponade, managed conservatively; 1 deep venous thrombosis
Stevenson 2008 (S10.1.2.1)	No	The previously ineffective AAD was continued for the first 6 months, after which time drug therapy was left to the discretion of the investigator.	Six months, after which time drug therapy was left to the discretion of the investigator	Echocardiogram and neurologist examination before and after ablation; office visit at 2 and 6 months, with ICD interrogation where applicable	Not specified	Three months with either 325 mg/day aspirin or warfarin if ablation had been performed over an area over 3 cm in length	Vascular access complications in 4.7%; no thromboembolic complications
Euro-VT 2010 (S10.1.2.7)	No	Drug management during follow-up was at the discretion of the investigator.	Drug management during follow-up was at the discretion of the investigator.	At 2, 6, and 12 months, with ICD interrogation where applicable	Investigators were encouraged to program ICD detection for slow VT for at least 20 beats or 10 seconds to allow nonsustained VT to terminate before therapy is triggered.	Not specified	No major bleeding or thromboembolic complications
VTACH 2010 (S10.1.2.8)	No	Discouraged	Discouraged	Every 3 months from ICD implantation until completion of the study	VF zone with a cutoff rate of 200–220 bpm and a VT zone with a cutoff CL of 60 ms above the slowest documented VT and ATP followed by shock	Not specified	One transient ischemic ST-segment elevation; 1 TIA
CALYPSO 2015 (S10.1.2.9)	No	Discouraged	Discouraged	At 3 and 6 months	Investigators were required to ensure that VT detection in the ICD is programmed at least 10 beats below the rate of the slowest documented VT.	At the discretion of the treating physician, anticoagulation recommended with aspirin or warfarin for 6–12 weeks
Marchlinski 2016 (S10.1.2.10)	Not required	Not dictated by the study protocol	Not dictated by the study protocol	At 6 months and at 1, 2, and 3 years	Not dictated by the study protocol	Per clinical conditions and physician preference	Cardiac perforation (n = 1), pericardial effusion (n = 3)
VANISH 2016 (S10.1.2.11)	No	Continued preprocedure antiarrhythmic medications	Not specified	A 3-month office visit, echo, ICD check; a 6-month office visit, ICD check; every 6 months thereafter, an office visit, ICD check	VT detection at 150 bpm or with a 10–20 bpm margin if the patient was known to have a slower VT. ATP was recommended in all zones. The protocol was modified to recommend prolonged arrhythmia detection duration for all patients.	Intravenous heparin (without bolus) 6 hours after sheath removal, then warfarin if substrate-mapping approach used or if more than 10 minutes of RF time	Major bleeding in 3 patients; vascular injury in 3 patients; cardiac perforation in 2 patients
SMS 2017 (S10.1.2.12)	No	At the discretion of the investigator	At the discretion of the investigator	At 3, 6, 9, and 12 months, and at 3- or 6-month intervals until completion of the study or until 33-month follow-up was reached	VF zone at 200–220 bpm, detection 18 of 24 beats, shock only; VT zone detection at least 16 consecutive beats, ATP, and shocks. Where VT rates were exclusively >220 bpm, VT zone at 160–180 bpm was recommended; where VT rates were <220 bpm, VT zone with a CL 60 ms above the slowest VT was recommended	Aspirin (250 mg/day) or warfarin as necessitated by the underlying heart disease	Two tamponades requiring pericardiocentesis

AAD = antiarrhythmic dug; ATP = antitachycardia pacing;CL = cycle length; ICD = implantable cardioverter defibrillator; NIPS = noninvasive programmed stimulation; RF = radiofrequency; TIA = transient ischemic attack; VF = ventricular fibrillation; VT = ventricular tachycardia.